Adverse perinatal outcome and mode of delivery in patients with meconium stained amniotic fluid

Abstract

Objective: To evaluate the perinatal outcome and mode of delivery in patients with Meconium stained Amniotic Fluid (MSAF). Material and Methods: This prospective observational study was carried out in Department of Obstetrics and Gynaecology, Government Medical College and Rajindra Hospital, Patiala, over a period of one year from January 2017 to December 2017. Total 4653 patients delivered over this time period. A total of 609 patients who had completed more than 37 weeks of gestation, with singleton pregnancies and cephalic presentations with meconium stained liquor were included in this study.Results: Among 609 patients, 63.1% of patients were unbooked cases, 36.9% of patients had at least 3 visits to our institute. Nulli parous patients accounted for 66.2% of the cases. 29.2% cases were beyond 42 weeks of pregnancy. 21.8% patients were of pregnancy induced hypertension. 20.2% patients were of oligo hydramnios, 10.2% patients were of Gestational Diabetes mellitus. In grade I MSAF 10.1% patients had abnormal CTG pattern, in Grade II MSAF 20.4% patients had abnormal CTG pattern, in Grade III MSAF 46.7% patients had abnormal CTG pattern. In grade I MSAF 26.4% patients delivered with LSCS, in grade II MSAF 45.7% patients delivered with LSCS, in Grade III MSAF 81.5% patients were delivered with LSCS. In patients with Grade I MSAF 14.1% babies were admitted to Neonatal intensive care unit, in Grade II MSAF 18.1% babies were admitted to Neonatal intensive care unit, in grade III MSAF 42.4% babies were admitted to Neonatal intensive care unit.Conclusion: Meconium stained amniotic fluid is really worrisome from both, obstetricians and paediatricians point of view, as it increases the caesarean rates, causes birth asphyxia, Meconium Aspiration Syndrome [MAS] and increase in neonatal intensive care unit admissions.